Ohio Code § 3901.387

§ 3901.387.

(A) When a provider or beneficiary submits a duplicative claim for payment for health

care services before the time periods specified in section 3901.381 of the Revised Code have elapsed for the original claim submitted, the third-party payer may deny the

duplicative claim.  Denials of claims determined to be duplicative by the department of insurance shall

not be considered by the department in a market conduct examination of a third-party

payer's compliance with section 3901.381 of the Revised Code .  The superintendent of insurance shall have the discretion to exclude an original

claim in determining a violation under section 3901.381 of the Revised Code . (B)(1) A third-party payer shall establish a system whereby a provider and a beneficiary

may obtain information regarding the status of a claim for payment for health care

services, provided the claim is not materially deficient.  A third-party payer shall inform providers and beneficiaries of the mechanisms that

may be used to gain access to the system. (2) If a third-party payer delegates the processing of payments to another entity, the

third-party payer shall require the entity to comply with division (B)(1) of this

section on behalf of the third-party payer.